Although the landscape of how we view those in the medical field is changing, there are still many of us who believe that our doctors are the end-all-be-all experts when it comes to our health.
“We know nothing, and we should always yield to their better judgment when it comes to our health.” This is actually the same narrative we hear with regard to fitness professionals: “We don’t know how to fuel and move our bodies, and therefore, we need to pay hundreds or thousands of dollars for experts, expensive equipment, packaged diet food, and prescribed diets.
There is a disconnect that happens between our bodies and our minds when we constantly buy into and operate from a narrative that says that we cannot be trusted. We rely on external rules and societal norms to mold us into who we think we’re supposed to be. We have no idea how to listen to our own innate wisdom, and this is very apparent when we step into the doctor’s office.
Why Doctors Still Use BMI, even if BMI is BS
When we go to the doctor, it’s almost a guarantee that we will be asked to step on the scale. Whether it’s an off-color comment from the nurse or just a look at the number that appears before us, this event can be very triggering for many. Doctors generally use this information to calculate your Body Mass Index and discern whether we’re underweight, normal, overweight or obese.
Although a poor and inaccurate determinant of health, BMI is still utilized as a diagnostic tool in most doctors’ offices. To me, this is lazy medical practice. “BMI has been used for decades at this point, so why should we change it now?” It’s also the quickest and most cost-effective way to categorize people’s weight in order to make an assessment about their health.
Why doctors prescribe weight loss
Again, this is an “easy” way to provide medical care. It’s very easy to identify weight, particularly if it’s above “normal,” as the problem for any ailments a patient comes in with. High blood pressure? Lose weight. Joint pain? Lose weight.
Uncovering the actual core cause of a patient’s issues would require a lot more time, money and diagnostic testing, which is why many doctors turn to weight loss as a first treatment option for anyone in a larger body; this is one of the most common forms of weight stigma seen in the medical community.
Why it‘s not (always) their fault
I’m not here to speak negatively about or stereotype those in the medical community. There are plenty of practitioners out there who go into their field–endure the years of school, student loans, and grueling shifts–to help people who are sick. I respect the hell out of them because it’s not a field I would thrive in. I have had some crumby doctors, but I’ve also had ones that have changed my life for the better and have even saved it multiple times.
As a result, we need to talk about why sometimes it’s not a doctor’s fault when they use BMI as a diagnostic and prescribe weight loss.
First and foremost, they are fallible human beings living in a fatphobic society just like you and me. They are not exempt from the perpetuated lies and the fear of what it means for our “health” and self-worth if we’re in a larger body. Yes, they should consider it their duty to educate themselves on fatphobia and how to speak to patients about weight in a neutral way; but we have to give some grace for the fact that none of us have been perfect on this undieting journey.
The second reason we need to show some compassion is because the medical field is changing. Doctors have less time with patients; they’re sometimes forced to spend only 15 minutes with patients, so they can see more patients and make enough money from insurance companies to pay the rest of the staff.
And third, the medical field is constantly changing. It’s such a vast field that it’s literally impossible to expect a doctor, one human being, to be up to date on all the medical advances and studies. My “day job” is as a high school English teacher, and I’ll tell you, nothing is more infuriating than when someone assumes I’ve read every novel, know every grammatical rule, and can define every word in the English language.
Suffice it to say, it’s up to us to take action and safeguard ourselves when we go to the doctor’s office.
- Refuse to get weighed – This is key. Many people are hesitant to stand up for themselves in this way, but unless you’re taking a medication that’s dosage is based on weight; a diagnosis like kidney disease where weight needs to be monitored for possible kidney failure; or you’re getting anesthesia for surgery, getting weighed is not medically necessary. Saying a simple, “No, thank you. I’d rather not” will suffice. You do not owe them an explanation.
- Set boundaries – This is your appointment for your health. If there is a course of action you do not agree with, you’re within your right to say, “I don’t feel comfortable with this treatment solution.” If they want to discuss your weight, you’re allowed to say, “I don’t feel comfortable talking about my weight as part of my treatment plan.”
- Advocate for yourself – If your doctor wants to prescribe a diet or weight loss, you can advocate for an alternative form of care by saying, “I would like to know what treatment plan you would suggest to someone in a smaller body.”
- Do your own research – Yes, “Dr. Google” can tell you you’re dying for just about any symptom you could have; but at the same time, knowledge is power. Look for alternative causes for your symptoms and advocate for those to be explored, as well.
- Find a HAES-aligned doctor – The Health at Every Size (HAES) Professional Listing Project is in the works by the Associate for Size Diversity and Health at the time of this writing. If it’s not completed yet by the time you’re reading this, though, you can Google “HAES doctors near me” to try and find a doctor that is willing to provide weight neutral care.
If you need more help navigating your health without weight loss as the main component, let’s chat. Go to www.freedomwithfoodandfitness.com/call to schedule a free call with me to discuss how you can approach health without dieting. Enrollment for Defy the Diet closes on December 12 and spots are limited, so if you want to change your relationship to your health and your weight, now is the time!